Successful mapping and ablation of a pediatric-onset non-reentrant
Non-reentrant fascicular tachycardia (NRFT) developed in a 6-year-old
Japanese boy. Because of the drug-resistant recurrences, he received
catheter mapping and ablation at age 10 years. An electrocardiogram
exhibited a superior left axis deviation, a right bundle branch
block-type configuration, and relatively narrow QRS with sharp R wave.
It suggested verapamil-sensitive ventricular tachycardia (VT), but
showed no sensitivity to verapamil or reentrant characteristics in the
electrophysiological study. Detailed VT mapping determined the earliest
presystolic Purkinje potential on the left posterior fascicle at the
mid-ventricular septum. Radiofrequency current applications to the
lesion led to his NRFT-free life without restriction for 16 months.